吉西他滨联合顺铂的新辅助化疗治疗局部晚期膀胱移行细胞癌

Research for neoadjuvant gemcitabine and cisplatin in patients with locally advanced bladder cancer

目的探讨吉西他滨联合顺铂(GC方案)的新辅助化疗方案治疗局部晚期膀胱移行细胞癌的临床疗效及毒性反应。方法 12例局部晚期膀胱移行细胞癌患者接受4个周期GC方案的新辅助化疗(吉西他滨1000mg/m2,第1、8天静脉滴注;顺铂20mg,第1～5天静脉滴注)。结果 12例均完成4个周期的GC方案化疗,总有效率58%,其中完全缓解2例,部分缓解5例,稳定3例,进展2例。6例患者化疗后行全膀胱切除术+回肠代膀胱术,3例经剖腹探查肿块无法切除而仅行放疗,2例患者因病情进展行姑息性化疗,1例患者拒绝手术治疗后仅行姑息性化疗。GC方案化疗的主要毒性为骨髓抑制,91%白细胞减少。结论吉西他滨联合顺铂是目前治疗局部晚期膀胱移行细胞癌有效、安全的新辅助化疗方案,为不能手术的局部晚期的膀胱移行细胞癌患者提供了新的治疗模式。

Objective To investigate the efficacy and toxicity of gemcitabine and cisplatin neoadjuvant chemotherapy in patients with locally advanced bladder cancer. Methods 12 patients with locally advanced bladder cancer received gemcitabine and eisplatin neoadjuvant chemotherapy 4 cycles （ gemeitabine 1 000 rag/ m^2, day1, 8; eisplatin 20 rag, day1-5）. Results All patients received regimen of GC 4 cycles, the responserate were 58%, there were 2 patients CR, 5 patients PR, 3 patients SD, 2 patients PD. After chemotherapy, 6 patients received radi- cal cysteetomy and bricker operation, 3 patients received palliative radiotherapy and 2 patients reeeived palliative chemotherapy due to disease progression, 1 patients denied operation and received palliative chemotherapy. The major toxieity was bone marrow suppression, leukopenia account for 91%. Conclusions The combination of GC is effective and well-tolerated when used as neoadjuvant chemotherapy in locally advanced bladder cancer, it provide the new therapeutic mode for unresectable locally advanced bladder cancer.